Technical Field of the Invention
[0001] The present invention is encompassed in the technical field of medical devices, and
particularly in the sector of osseointegrable implants for cervical corpectomy.
Background of the Invention
[0002] Applying prostheses in the spinal column is a technique which has been performed
for many years. In the first half of the 20
th century, spinal fusion and the instruments thereof were developed and applied as
techniques for treating spinal instability before the biomechanical principles involving
spinal instability were understood.
[0003] In recent years, with the development of new manufacturing materials and processes,
in addition to a more extensive study and a greater understanding of the biomechanical
principles, vertebral replacement devices have evolved tremendously, becoming components
which are indispensable in 21
st century neurosurgery treatments. The need for an additional surgical intervention
in a patient for removing cortical bone, which is necessary in older applications,
is thus prevented. It is estimated that approximately 400,000 vertebral replacements
due to vertebral fractures alone were performed in the US in 2009, generating a worldwide
income of more than 1 billion dollars. Furthermore, a clear trend towards an increased
use of fusion surgery can be seen due to the success cases and good results obtained.
[0004] The spine is naturally stable as a result of its anatomical configuration and of
the soft structures joining one vertebral body with the next. Nevertheless, if the
spine is subjected to a trauma which goes beyond the natural resistance of the bone
and ligament structures or if one develops a disease, a fracture or lesion of the
parts occurs, causing the instability thereof.
[0005] Spinal instability is not only a condition but a pathological consequence of a variety
of different spinal conditions, such as traumatic fractures, tumors, degenerative
diseases and infections.
[0006] These disorders are resolved with different types of surgical approaches, but the
surgical approaches which are most widely used today are the combination of corpectomy
and posterior fixation.
[0007] The surgery necessary for inserting the implant for corpectomy is performed by anterior
corpectomy and is done by means of an operation through the front skin folds in the
neck. Depending on each case, the intervertebral discs, the vertebral body (part or
all of it) are removed, and the area compressing the cord is liberated. Then, the
implant may or may not be inserted by means of using minimally invasive surgery (MIS).
Specific instruments will be necessary for said insertion. Subsequently, to prevent
excessive movement between two vertebrae, the option of fixing the vertebrae with
titanium plates is available.
[0008] The patient will normally need a postoperative cervical collar. After 4 or 5 months,
the bone mass is adequately formed, thus achieving adequate implant fixation and the
necessary spinal column stability.
[0009] An implant for corpectomy is a device the function of which is to replace a damaged
or collapsed vertebral body. The replacement device is supported on the adjacent vertebrae,
eliminating the movement between them and stabilizing the spine.
[0010] A system of plates screwed on the posterior face of the two adjacent vertebral bodies
which will be in permanent contact with the implant for corpectomy may be necessary
to achieve correct spinal stability and primary implant fixation. If said system is
not implanted, outer instruments would be necessary until sufficient osseointegration
(secondary fixation) is achieved and the implant is fixed. Since cement, screws or
similar components are not used to fuse the implant and the adjacent vertebral bodies,
and to thus stabilize the spine, achieving adequate osseointegration is essential.
Due to this requirement, many vertebral body replacement device designs contain an
inner cavity with holes in the walls which enable grafting in ground bone or synthetic
materials facilitating said osseointegration. Therefore, the bone is inserted in the
implant by using the holes of the wall, fusing the adjacent vertebrae and the implant
for corpectomy. These grafts provide the scaffold or foundation so that new bone grows
in the body of the patent and stimulate the production and fusion thereof. Surgeons
have historically obtained healthy material for bone graft from the body of the patient
himself/herself, generally from the iliac crest. Procuring the bone graft in this
manner requires an additional surgery causing postoperative pain, and there is also
a limit on the amount of bone which can be removed from the donating area. Therefore,
the materials which are most widely used today for fulfilling said function are autografts
(autogenous bone), xenografts and allografts, having their advantages and drawbacks.
The fusion achieved between the adjacent vertebrae limits the movement of the members
with respect to one another, whereby the implant is consolidated against axial stress,
rotational stress and lateral displacements in the spine.
[0011] Another prominent point of the implant design is the possibility of adjusting the
length thereof. Therefore, some designs offer the opportunity of adjusting the length
of the implant
in situ to the space between the adjacent vertebrae of each patient, providing the surgeon
with a margin for improvisation in order to better respond to the specifications of
each patient. Expandable implants of this type further provide significant clinical
advantages for the patient, as well as a smaller incision due to the fact that the
implant is narrower at the time of insertion since it expands inside the body of the
patient.
[0012] The vertebral replacement device can be manufactured from any biocompatible material.
The spinal column industry has traditionally been limited to manufacturing implants
for corpectomy from titanium alloys, Co-Cr alloys, stainless steel, ceramic and combinations
thereof mainly due to the fact that these materials have a good combination of mechanical
and biocompatibility properties. Nevertheless, with the development of new materials
and greater knowledge in handling them, their range has diversified. The incorporation
on the market of synthetic or natural tissues which may or may not be absorbable can
be understood in this context. One of these very widespread new materials is PEEK,
mainly due to its radiolucency which allows the surgeons to view the state of fusion.
[0013] Known implants for corpectomy are described, for example, in documents
US-4932975,
US-6190413,
US-6344057,
US-6352556,
US-6375683,
US-6562074,
US-6783547,
US-6808537,
US-6821298,
US-6908485,
US-6991653,
US-7008453,
US-7156874,
US-7311733,
US-7384431,
US-7674296,
US-7758648,
US-7815683,
US-7825134,
US-7879096,
US-2007/0068862-A1,
US-2007/0250171-A1,
US-2008/013060-A1,
US-2008/0167720-A1,
US 2009/0112325,
US-2009/0138083-A1,
US-2009/0138089-A1,
US-2009/0164019-A1,
US-201010028061-A1,
US-2010249934-A1,
DE-102008010607-A1 and
WO-2009/058578.
[0014] Nevertheless, conventional implants for corpectomy of the state of the art have structures
which do not allow their quick and at the same time effective osseointegration since
they have structures which do not offer effective support for the growth of the bone
of the patient from the grafts introduced into the implant.
Description of the Invention
[0015] The object of the present invention is to overcome the aforementioned drawbacks of
the state of the art by means of an osseointegrable implant for cervical corpectomy
intended for replacing a damaged vertebral body between two vertebral bodies adjacent
to the damaged vertebral body comprising a cylindrical spacing body with an upper
end and a lower end, a plurality of side holes communicated with the inside of the
spacing body for introducing graft material, upper anchoring means protruding from
the upper end of the spacing body for anchoring the implant to an upper adjacent vertebral
body, as well as lower anchoring means protruding from the lower end of the spacing
body for anchoring the implant to a lower adjacent vertebral body, in which
the spacing body comprises a reticular supporting structure comprising a plurality
of laterally interconnected columns of three-dimensional unit cells attached to one
another;
each unit cell encloses an inner space defined vertically between an upper base and
a lower base of the unit cell;
the inner spaces of the unit cells are laterally demarcated between vertical connecting
elements connecting the respective upper and lower bases of the cells.
[0016] The implant according to the present invention is obviously made of a biocompatible
material, such as titanium or CoCr.
[0017] In one embodiment of the implant, the columns of unit cells of the reticular structure
are formed by a plurality of vertical bars attached to one another by means of braces
extending between neighboring vertical bars;
the inner space of at least some of the unit cells is laterally demarcated between
respective vertical sections of at least three neighboring vertical bars;
each vertical section is defined between the upper base and the lower base of the
unit cell, and each brace of a unit cell connecting neighboring vertical bars extends
between the upper base and the lower base of the unit cell such that the unit cells
form stacked strata of unit cells.
[0018] The reticular structure of the spacing body is based on the reticular structures
(scaffolds) which are known for other applications in which supports are necessary
in new bone formation and growth. According to the present invention, the reticular
structure of the implants is intended to act as a support or scaffold facilitating
new bone formation and growth, thus facilitating osseointegration (secondary fixation)
of the implant, which must complement the fixation of the implant provided by the
anchoring means (primary stability). Likewise, the reticular structure of the spacing
body facilitates load distribution in the implant.
[0019] The vertical bars act in the direction of the compression loads and therefore provide
rigidity to the implant.
[0020] The neighboring vertical bars are preferably arranged equidistantly from one another,
whereas the braces connecting them to one another can extend horizontally or in an
inclined manner between neighboring vertical bars. The braces in turn preferably have
an inclination of 45°± 5° with respect to the vertical bars to which they are attached.
[0021] To optimize the mechanical biocompatibility, the side of the spacing body facing
the spinal cord can be provided with at least one concave wall, for example in the
form of a plate with a smooth outer surface, i.e., a curved wall intended to prevent
from damaging the spinal cord.
[0022] In a preferred embodiment of the implant according to the invention, the spacing
body comprises an upper body and a lower body coupled to one another by a vertical
expansion mechanism for adjusting the implant in height between the two adjacent vertebral
bodies. This expansion mechanism in turn comprises a screw which is threaded in respective
fixed housings in the upper body and in the lower body and has an upper helical thread
and a lower helical thread having opposite helical trajectories and a fixed outer
flange located between said threads.
[0023] In order to facilitate applying the rotating movement, the outer flange can be provided
with radial threaded passages communicated with the inner axial passage in which radial
threaded passages the tip of a suitable instrument can be introduced. These threaded
passages also serve for screwing a set-screw in at least one of the passages until
it presses against the wall of the upper tube and therefore blocks the rotation of
the screw.
[0024] The screw can have an inner axial passage through which it is guided in a sliding
manner on a telescopic assembly formed by an upper cylinder fixed to the fixed housing
of the upper body and a lower cylinder fixed to the fixed housing of the lower body
which extend in the inner axial passage of the screw. One of the cylinders is a tube
susceptible to sliding vertically on the other cylinder.
[0025] The tubes can in turn be provided with an anti-rotation system, such as for example
a key in one of the cylinders and a tube-shaped keyway in the other tube. The key
can be an outer axial rib in one of the tubes and in which case the keyway in the
other tube is a recess complementary to said rib. Since the tube is vertically slidable
on the lower cylinder, the telescopic assembly formed by the keyway and the key make
the rotation between both cylinders impossible. On the other hand, since the fixed
cylinders are located in the upper body and the lower body -1d-, respectively, the
relative rotation between said bodies is also made impossible.
[0026] In a preferred embodiment of the invention, the braces extend in an inclined manner
such that in at least some of the unit cells, each vertical bar is attached to at
least another neighboring vertical bar by means of a pair of inclined braces with
respective converging ends in the vertical section of a vertical bar in the intermediate
part of the cell and respective diverging ends attached to the other neighboring bar
in said upper part and in said lower part of the unit cell, respectively. According
to this preferred embodiment, in each unit cell of this type, the diverging ends of
each pair of braces are attached to a first vertical bar which is in turn attached
to the diverging ends of at least two pairs of braces the converging ends of which
are respectively attached to at least two second neighboring vertical bars that are
close to one another. These second vertical bars are arranged radially with respect
to the first vertical bar, and the braces attaching the second vertical bars with
the first vertical bar have respective longitudinal axes intersecting with the first
vertical bar, defining respective equiangular arches with respect to one another.
Therefore, the inner space of each cell is defined between the first vertical bar
and the second vertical bars.
[0027] The longitudinal axes of every two neighboring braces preferably define equiangular
arches of 15° to 90° with respect to one another, and more preferably equiangular
arches of 60°.
[0028] Since the function of the implant is to replace a damaged cervical vertebral body
between two adjacent vertebral bodies, its height must be oriented in the dimension
of the replaced vertebral body, i.e., about 18 mm, whereas its diameter conveniently
must not exceed 16 to 17 mm.
[0029] The reticular structure of the spacing body is susceptible to offering porosity,
i.e., an inner space, to allow housing the maximum amount of graft possible while
it must at the same time satisfactorily resist all the stresses to which the implant
is subjected such that the vertical bars and the braces must, on one hand, provide
adequate rigidity to the implant and on the other be sized so as to not excessively
reduce the porosity of the spacing body.
[0030] In this sense, in a convenient embodiment of the unit cells making up the spacing
body, at least some of the unit cells can have a height of approximately 3 mm to 6
mm that allows it to have the height equivalent to that of a cervical vertebral body,
approximately 18 mm, by means of superposing unit cell strata of the same height.
In the case of an implant without an expansion mechanism, the spacing body can be
formed from 6 to 3 strata of superposed unit cells from which there would be eliminated,
in the case of an implant with an expansion mechanism, the strata of unit cells the
place of which is being occupied by the part of the expansion mechanism occupying
the place between the upper body and the lower body of the spacing body. The vertical
bars and braces are in turn preferably cylindrical with a diameter which can be about
0.4 mm.
[0031] It must also be taken into account that before osseointegration and plasticization,
the spacing body is the element of the implant which withstands the greatest loads,
therefore it is desirable for its rigidity to be greater than that of the bone (having
an apparent elastic modulus of about 15 GPa), while at the same time the rigidity
is not too excessive to thus enable preventing negatively affecting the working of
the bone and subsequent bone loss by incorporating implants with a rigidity different
from the bone (stress shielding). Porosities of about 80% and adequate rigidities,
such as for example 19-20 GPa of apparent elastic modulus, can advantageously be achieved
with the design of the reticular structure.
[0032] The implant according to the present invention further offers the advantage that
its reticular body, in view of the repetition of its unit cells, is susceptible to
being manufactured preferably by additive manufacturing processes such as SLM (Selective
Laser Melting) or EBM (Electron Beam Melting).
[0033] As inferred from the foregoing, the present invention effectively overcomes the drawbacks
of the state of the art with a simple structure.
Brief Description of the Drawings
[0034] Aspects and embodiments of the invention are described below based on several schematic
drawings in which
Figure 1 is a front perspective view of an embodiment of an implant according to a
first embodiment of the invention;
Figure 2 is a sectional view through line A-A marked in Figure 1;
Figure 3 is a front perspective view of an embodiment of an implant according to a
second embodiment of the invention;
Figure 4 is a rear perspective view of the embodiment of the implant shown in Figure
3;
Figure 5 is a front perspective view showing the components of the implant shown in
Figure 3;
Figure 6 is a cross-section view of the screw of the expansion mechanism of the implant
shown in Figure 3;
Figure 7 is a side perspective view of a set-screw forming part of the expansion mechanism
of the implant shown in Figure 3;
Figure 8 is a front perspective view of the upper body of the implant shown in Figure
3;
Figure 9 is a bottom perspective view of the rear part of the upper body of the implant
shown in Figure 3;
Figure 10 is a front perspective view of the lower body of the implant shown in Figure
3;
Figure 11 is a top perspective view of the upper body of the implant shown in Figure
3;
Figure 12 is a top perspective view of a first embodiment of two adjacent unit cells
corresponding to the horizontal strata of the implant according to the present invention;
Figure 13 is a top plan view of the unit cells shown in Figure 12;
Figure 14 shows top plan sectional views through line B-B of three columns formed
by three strata of unit cells;
Figure 15 is a top plan view of the arrangement of the vertical bars and braces of
a unit cell according to the first embodiment illustrated in Figure 12;
Figure 16 is a top plan view of the arrangement of the vertical bars and braces of
a unit cell according to a second embodiment;
Figure 17 is a top plan view of the arrangement of the vertical bars and braces of
a unit cell according to a third embodiment;
Figure 18 is a bottom plan view of an embodiment of the upper body of the implant
with unit cells corresponding to Figures 15, 16 and 17;
Figure 19 is a view of a top perspective view of a second embodiment of the unit cell
according to the present invention;
Figure 20 is a view of a top perspective view of a third embodiment of the unit cell
according to the present invention;
Figure 21 is a view of a top perspective view of a fourth embodiment of the unit cell
according to the present invention;
Figure 22 is a view of a top perspective view of a fifth embodiment of the unit cell
according to the present invention;
Figure 23 is a view of a top perspective view of a sixth embodiment of the unit cell
according to the present invention;
Figure 24 is a view of a top perspective view of a seventh embodiment of the unit
cell according to the present invention;
Figure 25 is a view of a top perspective view of an eight embodiment of the unit cell
according to the present invention.
[0035] Reference numbers identifying the following elements can be seen in these drawings:
- 1
- spacing body
- 1a
- upper end
- 1b
- lower end
- 1c
- upper body
- 1d
- lower body
- 2
- vertical bars
- 2'
- vertical sections
- 2a
- first vertical bars
- 2b
- second vertical bars
- 2c
- vertical connecting walls
- 2d
- angled vertical connecting bars
- 2e
- through holes
- 3
- unit cells
- 3a
- upper base of the unit cell
- 3b
- lower base of the unit cell
- 4
- braces
- 5
- side holes
- 6a
- upper anchoring means
- 6b
- lower anchoring means
- 7
- screw
- 7a
- upper helical thread
- 7b
- lower helical thread
- 7c
- outer flange
- 7d
- inner axial passage
- 7e
- radial threaded passages
- 7f
- set-screw
- 7g
- outer thread
- 7h
- slot
- 8a, 8b
- fixed housings
- 9a
- upper tube
- 9b
- lower cylinder
- 9c
- keyway
- 9d
- key
- 10
- concave wall
- 11
- inner space
Embodiments of the Invention
[0036] According to the embodiments shown in Figures 1 to 18, the osseointegrable implant
for cervical corpectomy comprises a cylindrical spacing body -1- with an upper end
-1a- and a lower end -1b-, and a reticular supporting structure comprising a plurality
of columns of three-dimensional unit cells -3-. The columns -2- of unit cells -3-
of the reticular structure are formed by a plurality of vertical bars -2- attached
to one another by means of inclined braces -4- extending between neighboring vertical
bars -2-. The reticular structure acts as a support or scaffold in new bone formation
and growth thus facilitating implant osseointegration (secondary fixation).
[0037] The spacing body -1- further comprises a plurality of side holes -5- as well as upper
anchoring means -6a- in the form of spikes protruding from the upper end -1a-of the
spacing body -1- for anchoring the implant to an upper adjacent vertebral body (not
shown in the drawings) and lower anchoring means -6b-, also in the form of spikes,
protruding from the lower end -1 b- of the spacing body -1- for anchoring the implant
to a lower adjacent vertebral body (not shown in the drawings). The spikes having
a projecting height of 2 mm serve for the primary fixation of the implant in the adjacent
vertebral bodies and since they are elements which occupy little space at the ends
of the spacing body, they allow the bone of the adjacent vertebral bodies to grow
through most of the surfaces of said ends, thus enhancing implant osseointegration.
[0038] In the embodiment illustrated in Figures 1 and 2, the spacing body -1- is formed
by a single block of reticular structure and does not comprise any vertical expansion
mechanism which allows adjusting the height of the implant
in situ. This embodiment can be useful in specific cervical corpectomy applications, for example
applications in which complete implant osseointegration is sought.
[0039] Figures 3 to 11 show an embodiment of the implant expansible in height by means of
a vertical expansion mechanism. According to this embodiment, the spacing body -1-
comprises an upper body -1 c- and a lower body -1d- coupled to one another by the
vertical expansion mechanism for adjusting the implant in height between two adjacent
vertebral bodies.
[0040] The expansion mechanism comprises a screw -7- which is threaded in respective fixed
housings -8a, 8b- in the upper body -1 c- and in the lower body -1 d-, for which purpose
the screw -7- has an upper helical thread -7a- and a lower helical thread -7b- having
opposite helical trajectories and a fixed outer flange -7c- located between said threads
-7a, 7b-.
[0041] The screw -7- further comprises an inner axial passage -7d- through which it is guided
in a sliding manner on a telescopic assembly formed by an upper tube -9a-fixed to
the fixed housing -8a- of the upper body -1 c- and a lower cylinder -9b- fixed to
the fixed housing -8b-of the lower body -1d- which extend in the inner axial passage
-7d- of the screw -7-.
[0042] The upper cylinder -9a- is a tube having a keyway -9c- in the form of an axial recess
in its wall, whereas the lower cylinder -9b- has, protruding radially from its wall,
a key -9d- in the form of an outer axial rib complementary to the mentioned axial
recess. Since the tube -9a- is vertically slidable on the lower cylinder -9b-, the
telescopic assembly formed by the keyway -9c- and the key -8d- makes the rotation
between both cylinders impossible. On the other hand, since the fixed cylinders -9a,
9b- are located in the upper body -1c- and the lower body -1d-, respectively, the
relative rotation between said bodies -1c, 1d- is also made impossible.
[0043] When a rotating movement is applied to the outer flange -7c-, the screw -7- rotates
and, depending on the direction of the rotation, it expands or reduces the height
of the implant to adapt the height of the implant to the site existing between the
two adjacent vertebral bodies, which can be performed
in situ with the implant already introduced between said vertebral bodies. To apply the rotating
movement, the outer flange -7c- comprises radial threaded passages -7e- communicated
with the inner axial passage -7d- in which the tip of a suitable instrument can be
introduced. On the other hand, the threaded passages -7e- also serve for screwing
a set-screw -7f- in at least one of the passages until it presses against the wall
of the upper tube -9a-, and therefore the rotation of the screw -7- is blocked (see
Figure 4). The set-screw -7f- comprises an outer thread -7g- and a slot -7h- at one
of its bases serving for the application of a tightening tool, such as a screwdriver
for example.
[0044] In the embodiment shown in Figures 1 and 2, the side of the spacing body -1- facing
the spinal cord is provided with a concave wall -10- in the form of a plate with a
smooth outer surface intended for preventing damage to the spinal cord. In the case
of the embodiment shown in Figures 3 to 11, the concave wall -10- comprises two of
these plates.
[0045] As can be seen in Figures 12 to 17, each unit cell -3- encloses an inner space -11-
defined vertically between an upper base -3a- and a lower base -3b- of the unit cell
-3-. Likewise, the inner space -11- of each unit cell -13- is laterally demarcated
between respective vertical sections -2'- of at least three neighboring vertical bars
-2a, 2b- arranged equidistantly from one another. Each vertical section -2'- is defined
between the upper base -3a- and the lower base -3b- of the unit cell -3-.
[0046] On the other hand, each brace -4- of a unit cell connecting neighboring vertical
bars -2- extends in an inclined manner between the upper base and the lower base of
the unit cell such that the unit cells -3- form stacked strata of unit cells -3-.
[0047] As inferred from Figures 1 to 18, in the embodiments illustrated therein, each vertical
bar -2a, 2b- in each unit cell -3- is attached to at least another neighboring vertical
bar -2b, 2a- by means of a pair of inclined braces -4- with an inclination of 45°,
with respective converging ends in a vertical section of a vertical bar -2b- in the
intermediate part of the cell -3- and respective diverging ends attached to the other
neighboring vertical bar -2a- in said upper part and in said lower part of the cell
-3-, respectively.
[0048] In the embodiments illustrated in Figures 12 and 14, in each unit cell -3- the diverging
ends of each pair of braces -4- are attached to a first vertical bar -2a-whereas the
converging ends of the respective pairs of braces -4- are respectively attached to
at least two second neighboring vertical bars -2b- that are close to one another.
These second vertical bars -2b- are arranged radially with respect to the first vertical
bar -2a-. Each brace -4- of each pair of braces -4- has a longitudinal axis intersecting
with the first vertical bar -2a-. The longitudinal axes of the respective pairs of
neighboring braces -4- intersect with the first vertical bar -2a- in equiangular arches
of 60°.
[0049] In Figure 18, in which the first vertical bars -2a- are depicted as solid circles,
an embodiment of the upper body -1 c- of the spacing body of the implant made from
unit cells such as those shown in Figures 12 to 17 can be seen in more detail. The
upper body -1 c- integrates the housing -8a- and the upper tube -9a-. As can be seen,
the vertical bars -2a, 2b- and the attachment braces -4- form the reticular structure
defined above in the present description.
[0050] Figures 19 to 25 show other embodiments of the unit cells -3- from which the reticular
structure of the spacing body -1- of the implant according to the present invention
can be completely or partially made.
[0051] Figure 19 thus illustrates an embodiment of a unit cell -3- the inner space -11-
of which is laterally demarcated by four vertical sections -2'- attached to one another
by means of respective pairs of inclined inner braces -4- with converging ends centrally
attached to one another in the inner space -11-. The diverging ends of the two braces
-4- forming each pair of braces -4- are attached to one of the vertical sections -2'-
in said upper part and in said lower part of the cell -3-, respectively.
[0052] Figure 20 illustrates an embodiment of a unit cell -3- the inner space -11- of which
is also laterally demarcated by four vertical sections -2'-. The vertical sections
-2-- are attached to one another by means of respective pairs of inclined radial inner
braces -4- with converging ends centrally attached to one another in the inner space
-11-. Likewise, the diverging ends of the two braces -4- forming each pair of braces
-4- are attached to one of the vertical sections -2'- in said upper part and in said
lower part of the cell -3-, respectively. According to this embodiment, the neighboring
vertical sections -2'- are further attached by respective pairs of outer braces -4-
the respective converging ends of which are also attached to one another, and the
upper diverging ends of which are attached to neighboring vertical sections -2'- in
the area of the upper base -3a- of the unit cell -3-, whereas the lower diverging
ends thereof are attached to neighboring vertical sections -2'- in the area of the
lower base -3b- of the unit cell -3-.
[0053] In the embodiment illustrated in Figure 21, the inner space -11- is also laterally
demarcated between four vertical sections -2'-. Each vertical bar -2'- is attached
to its neighboring vertical section -2- by means of a pair of inclined inner braces
-4- with respective converging ends in an intermediate part of a vertical section
-2'- and respective diverging ends attached to the other neighboring vertical section
-2- in the area of the upper part -3a- and in the lower part -3b- of the cell -3-,
respectively. On the other hand, the vertical sections -2'- are attached to one another
by means of inclined radial inner braces -4-. Specifically, an upper assembly of radial
braces -4- and a lower assembly of radial braces -4- can be seen. The upper assembly
of braces -4- comprises respective pairs of inclined radial inner braces -4- with
converging ends centrally attached to one another in the inner space -11- at a height
defined between the upper base -3a- and the intermediate part of the cell -3-, whereas
the diverging ends of the two braces -4- forming each pair of braces -4- are attached
to one of the vertical sections -2'- in the area of the upper base -3a- and in said
intermediate part of the cell -3, respectively. On the other hand, the lower assembly
of braces -4- comprises respective pairs of inclined radial inner braces -4- with
converging ends centrally attached to one another in the inner space -11- at a height
defined between the intermediate part and the lower base of the cell -3-, whereas
the diverging ends of the two braces -4- forming each pair of braces -4- are attached
to one of the vertical sections -2'- in the intermediate part and the lower base of
the cell -3-, respectively.
[0054] Figure 22 illustrates the embodiment of a unit cell -3- in which the inner space
-11- is laterally demarcated by six angled bars -2d- with respective upper converging
ends in the upper base -3a- of the unit cell -3- and respective lower converging ends
in the lower base -3-of the cell -3-.
[0055] In the embodiment of the unit cell -3- shown in Figure 23, the inner space -11-is
also laterally demarcated by six angled bars -2d- with respective upper converging
ends in the upper base -3a- of the unit cell -3- and respective lower converging ends
in the lower base -3- of the unit cell -3-. The upper converging ends and the lower
converging ends of the angled bars are attached to opposite ends of a vertical section
-2'- of a vertical bar (2) of the columns of unit cells (3) of the reticular structure.
[0056] Finally, in the embodiments illustrated in Figures 24 and 25, the respective vertical
connecting elements connecting the respective upper and lower bases -3a, 3b- of the
unit cell -3- are vertical connecting walls -2c- provided with through holes -2e-
which in the case of Figure 24 are rectangular and in the case of Figure 25 circular.
1. Osseointegrable implant for cervical corpectomy intended for replacing a damaged vertebral
body between two vertebral bodies adjacent to the damaged vertebral body comprising
a cylindrical spacing body (1) susceptible to housing graft material therein, and
with an upper end (1 a) and a lower end (1 b), a plurality of side holes (5) communicated
with the inside of the spacing body for introducing graft material, upper anchoring
means (6a) protruding from the upper end (1a) of the spacing body (1) for anchoring
the implant to an upper adjacent vertebral body, and lower anchoring means (6b) protruding
from the lower end (1 b) of the spacing body (1) for anchoring the implant to a lower
adjacent vertebral body, characterized in that
the spacing body (1) comprises a reticular supporting structure comprising a plurality
of laterally interconnected columns of three-dimensional unit cells (3) attached to
one another; each unit cell (3) encloses an inner space (11) defined vertically between
an upper base (3a) and a lower base (3b) of the unit cell (3);
the inner spaces (11) of the unit cells (3) are laterally demarcated between vertical
connecting elements (2, 2a, 2b, 2c, 2d) connecting the respective upper and lower
bases (3a, 3b) of the cells (3).
2. Implant according to claim 1, characterized in that
the columns of unit cells (3) of the reticular structure are formed by a plurality
of vertical bars (2, 2a, 2b) attached to one another by means of braces (4) extending
between neighboring vertical bars (2, 2a, 2b);
the inner space (11) of each unit cell (3) is laterally demarcated between respective
vertical sections (2') of at least three neighboring vertical bars (2, 2a, 2b);
each vertical section (2, 2') is defined between the upper base (3a) and the lower
base (3b) of the unit cell (3), and each brace (4) of a unit cell (3) connecting neighboring
vertical bars (2, 2a, 2b) extends between the upper base (3a) and the lower base (3b)
of the unit cell (3) such that the unit cells (3) form stacked strata of unit cells
(3).
3. Implant according to claim 2, characterized in that the neighboring vertical bars (2, 2a, 2b) are arranged equidistantly from one another.
4. Implant according to claim 2 or 3, characterized in that the braces (4) extend horizontally between neighboring vertical bars (2, 2a, 2b).
5. Implant according to claim 2 or 3, characterized in that the braces (4) extend in an inclined manner between neighboring vertical bars (2,
2a, 2b).
6. Implant according to claim 5, characterized in that the braces (4) have an inclination of 45°± 5° with respect to the vertical bars (2,
2a, 2b) to which they are attached.
7. Implant according to claim 6 or 7, characterized in that in at least some of the unit cells (3), each vertical bar (2, 2a, 2b) is attached
to at least another neighboring vertical bar (2, 2a, 2b) by means of a pair of inclined
braces (4) with respective converging ends in the vertical section (2') of a vertical
bar (2, 2a, 2b) in an intermediate part of the unit cell (3), and respective diverging
ends attached to the other neighboring vertical bar (2, 2a, 2b) in said upper part
(3a) and in said lower part (3b) of the unit cell (3), respectively.
8. Implant according to claim 7, characterized in that in at least some of the unit cells (3)
the diverging ends of each pair of braces (4) are attached to a first vertical bar
(2a);
the first vertical bar (2a) is attached to the diverging ends of at least two pairs
of braces (4) the converging ends of which are attached respectively to at least two
second neighboring vertical bars (2b) that are close to one another;
the second vertical bars (2b) are arranged radially with respect to the first vertical
bar (2a);
the neighboring braces (4) attaching the second neighboring vertical bars (2b) with
the first vertical bar (2a) have respective longitudinal axes intersecting with the
first vertical bar (2a), defining respective equiangular arches with respect to one
another;
the inner space (11) of each unit cell (3) is defined between the first vertical bar
(2a) and the second vertical bars (2b).
9. Implant according to claim 8, characterized in that the longitudinal axes of said neighboring braces (4) define equiangular arches of
15° to 90° with respect to one another.
10. Implant according to claim 9, characterized in that the longitudinal axes of said neighboring braces (4) define equiangular arches of
60° with respect to one another.
11. Implant according to claim 1, characterized in that the respective vertical connecting elements connecting the respective upper and lower
bases (3a, 3b) of at least one of the cells (3) are vertical connecting walls (2c)
provided with through holes (2e).
12. Implant according to claim 1, characterized in that the respective vertical connecting elements connecting the respective upper and lower
bases (3a, 3b) of at least some of the cells (3) are angled vertical connecting bars
(2d) with respective upper converging ends in the upper base (3a) of the unit cell
(3) and respective lower converging ends in the lower base (3b) of the unit cell (3).
13. Implant according to any one of the preceding claims, characterized in that the spacing body (1) comprises at least one concave wall (10).
14. Implant according to any one of the preceding claims, characterized in that
the spacing body (1) comprises an upper body (1c) and a lower body (1d) coupled to
one another by a vertical expansion mechanism for adjusting the implant in height
between the two adjacent vertebral bodies,
the expansion mechanism comprises a screw (7) which is threaded in respective fixed
housings (8a, 8b) in the upper body (1c) and in the lower body (1d);
the screw (7) has an upper helical thread (7a) and a lower helical thread (7b) having
opposite helical trajectories and a fixed outer flange (7c) located between said threads
(7a, 7b).
15. Implant according to claim 14, characterized in that the screw has an inner axial passage (7d) through which it is guided in a sliding
manner on a telescopic assembly formed by an upper cylinder (9a) fixed to the fixed
housing (8a) of the upper body (1 c) and a lower cylinder (9b) fixed to the fixed
housing (8b) of the lower body (1d) which extend through the inner axial passage (7d)
of the screw (7), at least one of said cylinders (9a, 9b) being a tubular cylinder
(9a) which slides vertically on the other cylinder.